Coronary computed tomography angiography (CCTA) is a clinically reliable method for detecting coronary stenosis for the patients with coronary artery disease (CAD) [1, 2]. However, the presence of coronary stenosis is not necessarily image findings which indicate the functional stenosis [3]. Therefore, adenosine-stress myocardial perfusion scintigraphy (MPS) have been conventionally played a major clinical role for the diagnosis of the functional coronary stenosis. Recently, to overcome the invasiveness of MPS, fractional flow reserve computed tomography (FFR-CT) which invasively simulate coronary hemodynamics is proposed and applicated...

Patient population: This retrospective observational study was approved by the institutional review board and conducted in accordance with the 1964 Declaration of Helsinki. Data of the consecutive 55 patients (17 men, 38 women; mean age, 68 years ± 10 [standard deviation]) of whole heart dynamic CCTA during a cardiac cycle obtained by dose modulated scan and of adenosine-stress MPS were retrospectively analyzed. All patients had been clinically referred for suspected CAD. The patient exclusion criteria were as follows: (i) previous coronary bypass surgery; (ii) contraindications...

Four RCAs out of a total of 165 vessels in 55 patients were excluded because they were after bypass surgery. MPS showed ischemia in 32 coronary territories in 26 patients, and CCTA showed 55 significant coronary stenosis (moderate or severe stenosis) in 41 patients. (Table 1). There were statistically significant differences of CT-iFR between the patients with and without ischemia diagnosed by MPS (Figure 3). ROC analyses revealed use of significant stenosis on CCTA and CT-iFR for detection of myocardial ischemia from MPS with an...

CCTA has traditionally made a significant contribution as a screening tool with high negative predictive value for coronary stenosis [8, 9]. Furthermore, in recent years, CT imaging is expected to be a new four-dimensional diagnostic tool such as CT-FFR with the advance of CT equipment and computers. Our proposed CT-iFR can be calculated in not only coronary distal site but also any coronary site. It is effective for clinical use to display as the color coded image as shown in Figure 5. Also, image processing...

M. Kawakubo; Fukuoka/JP - nothing to disclose M. Nagao; Tokyo/JP - nothing to disclose E. Watanabe; Tokyo/JP - nothing to disclose A. Sakai; Tokyo/JP - nothing to disclose S. Suzaki; Tokyo/JP - nothing to disclose Y. Shimomiya; Tokyo/JP - Employee at Ziosoft Inc. S. Sakai; Shinjuku-ku, TOKYO/JP - nothing to disclose K. Fukushima; Saitama/JP - nothing to disclose

Budoff MJ, Dowe D, Jollis JG et al (2008) Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J Am Coll Cardiol. 52:1724-32. Hamon M, Biondi-Zoccai GG, Malagutti P et al (2006) Diagnostic performance of multislice spiral computed tomography of coronary arteries as compared with conventional invasive coronary angiography: a meta-analysis. J Am...